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Putting Evidence into Practice: A New Tool for Family Physicians



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Am Fam Physician. 2001 Jun 1;63(11):2099.

In this issue you will find a new department that is based on the Cochrane Database of Systematic Reviews in The Cochrane Library. The editorial “Helping Physicians Make Evidence-Based Decisions” by Lorne Becker, M.D. (page 2130) introduces the series, which begins on page 2245. It will be unlike any other department in the journal to date and arises from our recognition of the frequent gap between medical evidence and clinical practice.

“Cochrane for Clinicians: Putting Evidence into Practice” debuts with a piece titled “Should We Recommend Nicotine Replacement Therapy?” by Sean P. David, M.D., S.M., assistant professor of family medicine at Brown University School of Medicine, Pawtucket, R.I. The piece offers a summary of a review from the Cochrane Library, along with a guide to help physicians interpret the evidence. A clinical scenario opens the piece, and a specific clinical question about the case is answered on the basis of evidence in the Cochrane review. A full critique of the review is also provided.

But just what are Cochrane reviews? Dr. Becker provides must-read background on the Cochrane Collaboration in the editorial on page 2130. Basically, the Cochrane Collaboration is an international organization that was formed to determine the effectiveness of medical interventions through meta-analyses of existing randomized controlled trials. The Cochrane Library now contains more than 850 reviews completed by members of the collaboration.

Written by family physicians, AFP's “Cochrane for Clinicians” will offer the evidence-based guidance that family physicians need. Upcoming topics include treatment of bronchitis, otitis media, dyspepsia, sinusitis and trichomoniasis.

The concept for the series was developed by one of AFP's assistant medical editors, Clarissa C. Kripke, M.D., San Francisco. When Dr. Kripke first joined the journal staff nearly three years ago as the medical editorial fellow, she came to her first annual editors' conference with ideas about why and how to explicitly label the evidence behind recommendations offered in AFP. Her work eventually led to the idea of incorporating the Cochrane reviews into practical pieces tailored for family physicians.

At the same time, AFP's editor Jay Siwek, M.D., has been seeking ways of labeling the strength of evidence behind key recommendations in clinical reviews, and he has finalized plans for introducing an evidence-ranking system into the journal. We hope you enjoy watching as AFP's plans unfold to help clinicians put evidence into practice.



Copyright © 2001 by the American Academy of Family Physicians.
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